Efficacy of Chinese herbal medicine for lumbar disc herniation: a systematic review of randomized controlled trials.

OBJECTIVE

This is a review of the effects of Chinese herbal medicine (CHM) used alone to treat lumbar disc herniation (LDH).

METHODS

A literature search of the following electronic databases from their inception to February 2013 was conducted: Chinese Biomedical databases, Chinese National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database, Cochrane Library, Web of Science, MEDLINE, and EMBASE. Randomized controlled trials where CHM had been used to treat LDH were selected. Data extraction, quality assessment, and data analysis were carried out by two independent reviewers.

RESULTS

Of the 2415 studies identified, eight with complete data on 1146 patients were selected. The methodological quality was poor in all trials. Five studies reported that CHM was better than Western Medicine [OR = 2.81, 95% CI (1.27, 6.18); OR = 3.34, 95% CI (1.92, 5.79); OR = 2.22, 95% CI (1.08, 4.57); OR = 6.67, 95% CI (1.34, 33.28); and OR = 1.94, 95% CI (1.23, 3.06)]. Two studies reported that the clinical outcome was better in CHM groups than in physiotherapy and placebo groups, [OR = 3.02, 95% CI (1.08, 8.46); and OR = 2.67, 95% CI (1.26, 5.64), respectively], whereas one study reported no difference between CHM and physiotherapy groups. One study reported that CHM resulted in higher Japanese Orthopedic Association scores [MD = 7.78, 95% CI (6.67, 8.89)] than in a control group and another that participants treated with CHM had lower Visual Analogue Scale scores [MD = -0.72, 95% CI (- 0.86, -0.58)] than those in a control group. Three studies reported that the adverse effects of CHM and Western Medicine did not differ significantly [OR = 0.10, 95% Cl (0.01, 1.85); OR = 0.19, 95% CI (0.01, 4.07); and OR = 0.07, 95% CI (0.00, 1.32)].

CONCLUSION

CHM may be more effective than other interventions for LDH; however, methodological weaknesses in the studies assessed in this review prevent a definitive conclusion. More high-quality large-scale studies are required to clarify this matter.